The most common types of foot and ankle injuries occur when the ligaments and tendons in the foot or ankle are stretched or torn.

Tendons are elastic tissues that connect the muscles to the bones and joints. The largest and strongest tendon of the foot is the Achilles tendon, which extends from the calf muscle to the heel.

The peroneal tendons, located side-by-side behind the outer ankle bone, stabilize the foot and ankle and protect them from sprains.

When tendons tear, this is called a "rupture."

Ligaments hold the tendons in place and stabilize the joints. Sprains -- injury to a ligament -- are among the most common orthopaedic injuries.

An ankle sprain is an injury to the ligament of the ankle joint and occurs when the ankle ligaments tear or stretch suddenly. A foot sprain occurs when the ligaments that cross the foot tear.

What causes ligament injuries and tendon injuries?

Sprains and tendon injuries are common sports and running injuries, but they can also happen during everyday activities like walking or climbing stairs.

Foot and ankle ligament injuries occur when an excessive stretching force is applied to the ligaments. This commonly happens when the foot is turned inward or inverted.

Repetitive ankle motions in sports, such as running and jumping, can lead to wear and tear on the tendons. Those with tendonitis -- or inflamed tendons -- may have weaker tendons that are more susceptible to tears. Also, direct trauma can cause a tendon rupture.

Tendonosis occurs when the tendon fails to heal after an injury or trauma and the tendon itself begins to degenerate.

What do ligament injuries and tendon injuries feel like?

Tendon and ligament injuries are both characterized by:

• Pain
• Swelling, often severe
• Redness and warmth around the injured area
• Bruising
• Limited mobility
• Inability to bear weight on the injury
• The sound of a "pop" or "snap" at time of injury

How do I know if I have a ligament injury or tendon injury?

A physical examination by your doctor will properly diagnose the injury. The exam will focus on pain and range of motion, ensuring that there is no serious injury -- like fracture -- or any underlying conditions like tendonitis.

X-ray imaging and magnetic resonance imaging (MRI) will confirm diagnosis.

How are ligament and tendon injuries treated?

Sprains and tendon injuries should be treated by the following:

• Rest: Keeping off of your injury will prevent further problems and promote proper healing.
• Ice: Applying ice to the injury will counteract the increased blood flow to the injury, reducing the swelling and inflammation.
  
  Do not apply the ice directly to the skin. Use a towel or bag to wrap the ice, as direct exposure to the skin may cause frostbite.
• Compression: Immobilize the injury with elastic wraps. This helps prevent inflammation and provides extra ankle support.
• Elevation: Prop the injured limb up so that it is elevated above the level of your heart. This helps promote healing by allowing your body to absorb fluid that has leaked into the tissue following the injury.

In some cases, surgery may be recommended to repair the tendon or ligament if the patient is not healing with conservative treatments is or the tear is severe.

Learn about treatments at Duke.

Duke Orthopaedics treats ligament and tendon injuries at locations throughout North Carolina, including Raleigh, Durham, Cary, and Chapel Hill, North Carolina.

Treatment Videos

Watch an educational video about treatment for peroneal tendonitis.

Watch an educational video about treatment for achilles tendon injury.